Senior Process Executive

Stong back ground in Payment Posting with Analytical Skills

Position Title: Senior Process Executive

Experience: 2+ Years

Roles and Responsibilities

• Advanced Payment Posting
• EOB / ERA Analysis
• Denial & Exception Identification
• Payment Reconciliation
• Credit Balance & Refund Review
• Unapplied / Unidentified Payments
• Quality Control
• Team Support & Mentoring
• Client & Process Compliance
• Productivity & Performance
• Process and post insurance and patient payments accurately from EOBs, ERAs, EFTs, checks, and other payment sources.
• Handle complex payment scenarios, including multiple claims, split payments, recoupments, takebacks, refunds, and credit balances.
• Ensure payments, contractual adjustments, patient responsibility, and balance transfers are accurately posted.
• Follow client-specific payment posting guidelines and contractual rules.
• Perform detailed review of EOBs and ERAs.
• Analyze payment variances and identify incorrect or missing contractual adjustments.
• Identify underpayments, overpayments, zero-pay claims, incorrect patient responsibility, and payer discrepancies.
• Validate that the claim-level and service-line-level amounts reconcile with the remittance.
• Identify complex denial and rejection patterns during payment posting.
• Categorize denials and route them to the appropriate AR/Denials team.
• Identify recurring payer issues and escalate trends to the Team Lead/Manager.
• Review unusual transactions and determine the appropriate next action based on SOP.
• Perform daily and batch-level reconciliation of payments.
• Reconcile EOB/ERA payment batch system posting account balance.
• Identify missing, duplicate, incorrect, or unidentified payments.
• Investigate discrepancies and coordinate with the appropriate internal/client team for resolution.
• Identify credit balances and potential overpayments.
• Review refund-related transactions according to client guidelines.
• Escalate accounts requiring refund or recoupment processing.
• Ensure credit balances are properly documented and tracked.
• Research and resolve unapplied or unidentified payments.
• Use available remittance, patient, claim, payer, and account information to identify the correct account.
• Maintain an appropriate tracker for unresolved payments and follow up within the required TAT.
• Perform self-audits and peer reviews when assigned.
• Review junior team members transactions for accuracy.
• Identify recurring errors and provide corrective feedback.
• Support the team in maintaining required quality and accuracy benchmarks.
• Guide Junior Payment Posters on complex transactions and EOB/ERA interpretation.
• Conduct knowledge-sharing sessions and process refreshers.
• Support new-hire training and nesting activities.
• Act as the first point of escalation for process-related questions.
• Follow client-specific SOPs, payer guidelines, and workflow requirements.
• Maintain compliance with HIPAA, data security, and organizational policies.
• Communicate process issues and recurring challenges to the Team Lead/Manager.
• Participate in process improvement initiatives.
• Consistently meet or exceed assigned productivity and quality targets.
• Manage daily workloads according to TAT and priority requirements.
• Support the team during month-end and high-volume periods.
• Minimize rework, posting errors, and unresolved exceptions.

Candidate Profile

Preferred background:

• Payment Posting
• Cash Posting
• EOB/ERA Processing
• AR
• Denials

The ideal senior candidate should be able to work independently on complex payment transactions, identify posting discrepancies, reconcile payments, resolve unapplied payments, analyze EOB/ERA information, and support junior team members without constant supervision.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.